EP - Exemplary Professional Practice

EP3: Professional Practice Model-Describe and Demonstrate the structure(s) and process(es) that include direct-care nurse involvement in tracking and analyzing nurse satisfaction or engagement data.

Jersey CityMedicalCenter has utilized the National Database of Nursing Quality Indicators (NDNQI) to measure nurse engagement. Our surveys are conducted on an annual basis. The most recent survey was conducted in June, 2012. The last survey in 2011, we established a goal for participation on the survey which we set at 85%. We surpassed that goal in 2011 with 98% nurse participation and again in 2012 with 95% participation.

Tracking and analyzing engagement survey results occurs at several levels of the organization. Senior leaders, directors and managers receive engagement survey results in their areas of responsibility. Additionally, they are provided with education and an overall breakdown so they can interpret the results and develop the necessary action plans for their individual units. Data is examined overall organizationally and individually on each unit.

Direct care nurses analyze data at the Division of Nursing Level and at the Unit level. At the Division of Nursing level the Nurse Satisfaction and Retention Council is charged with developing and promoting strategies to engage and retain nurses (Reference EP3-A). The following is a list of membership of this Council:

Nurse Satisfaction and Retention Council Membership

EP3-Table 1

Data on Nurse Satisfaction is presented at this meeting and strategies are developed in order to address specific issues. An overall action plan is developed for the units which includes input from the nurses on the Council that represent those units (Reference EP3-B). The plan lists the issues and the units which are scoring below the benchmark (we use the Teaching Hospital Mean). The discussion and plan follows. This action plan is rolled out on the individual units and implemented. Nurse Managers are notified if any barriers exist that they can address and assist with.

At the Unit level, staff nurses participate in the implementation process and discuss issues and or barriers to accomplishing their goals. Discussions occur with Nurse Managers or via unit-based quality committees on each unit to discuss issues pertaining to engagement scores or during Staff Meetings held by the Nurse Manager. Managers, assisted by their staff, are able to develop plans of action that are individualized to their units. They identify priorities for improvement, initiatives targeted to address issues and needed resources and support in order to achieve their goals.

Example of NICU direct care nurses involvement in nurse engagement data

One of the issues in the 2011 Nurse Satisfaction survey was the Newborn Intensive Care units overall scores in response to the question “perceived quality of care.” Under the guidance of Michele Dickerson MSN, RN, RNC-NIC, Nurse Educator for the unit, a unit-based Journal Club was established. The nurses involved with this endeavor are Jocelyn DellaCruz-Torres BSN, RN, RNC-NIC Staff Nurse in the NICU who was anxious to Chair the meeting, and Jessica Chineme BSN, RN who is the co-chair of the Journal Club. The only articles that are selected are peer-reviewed journal articles from the National Association of Neonatal Nurses (NANN) and the Association of Neonatal Nurses (ANN). They meet every other month and the selection of articles is rotated among the group membership. Ms. DellaCruz-Torres states: “This is an important process for us. As nurses, we must keep updated on recent advances and insure that learning is a life-long process. The last article that we discussed was on Thermoregulation of late preterm infants. This article was very informative because we learned how to use the chemical transport mattress. These articles help to improve quality related to practice issues.”

When new procedures/technology are introduced via the Journal Club, it is discussed during a Unit Practice Council or the unit-based Performance Improvement Council in order to implement if possible.

Example of direct care nurses involvement in nurse engagement in the intensive care unit

The intensive care unit had ranked low on the nurse satisfaction survey in so far as Job Enjoyment. In order to provide unification of the staff, several community projects were initiated that the staff could all participate in. On Thanksgiving Lisa Williams-Peace BSN, RN, Staff Nurse from ICU spearheaded a project. Participants pooled their money and resources and rented a church building. They all prepared food in order to distribute to the poor on Thanksgiving Day. Melissa Masse BSN, RN, Staff Nurse in ICU was a leader in assembling a team to orchestrate the donation of school supplies to the Boys and Girls Club of America which is located nearby (Appendix EP3-A). The team place receptacles throughout the hospital, whereby visitors and other employees could contribute book-bags, books, binders, pencils, pens and colored markers. These school supplies were then distributed to the Boys and Girls Club in time for the start of the school year.

This group also participated in TeamBuilding and further unification by the development of a softball team of the Critical Care Division. Anyone could join the team: nurses, patient care technicians, respiratory therapists and physicians. This process helped to solidify the unit by bringing the staff together and participating in a team function.

Example of direct care nurses involvement in nurse engagement in the Labor and Delivery Unit

Nurses on the Labor and Delivery Unit were concerned that they ranked lower than the mean in nursing participation in hospital affairs. They determined to strengthen this area and increase their council-wide participation. Vivian Chang BSN, RN, Staff Nurse on Labor and Delivery Unit, determined to become a champion for enhancing the Unit Practice Councils. She offered the sessions when most of the nurses were available to attend and created meeting minutes and a binder so that even if nurses could not attend the meetings, they would be apprised of the discussions. Two staff members from the Labor and Delivery Unit, Andrea Dirubba BSN, RN, Staff Nurse L&D, and Deborah Hall BSN, RN, Staff Nurse L&D, were nominated by their Nurse Manager to participate in the Presidents Council, which meets on a quarterly basis. This Council is chaired by The Chief Executive Officer and is held off-site for an entire day at a nearby restaurant. The goal of this session is to team build with employees of the MedicalCenter and include them in the strategic planning process of the organization. Although these staff members were nominated by their manager, they had expressed an interest in becoming part of this process.